对乳腺癌患者使用正念减压法(MBSR)--Meta 分析。

IF 2.7 3区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY BMC Psychology Pub Date : 2024-11-01 DOI:10.1186/s40359-024-02092-y
Xue Dong, Yan Liu, Kui Fang, Zhihan Xue, Xixi Hao, Zezhou Wang
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引用次数: 0

摘要

背景:正念减压(MBSR)干预已被广泛用于减轻癌症患者的症状负担,其有效性已得到证实。然而,MBSR 对乳腺癌患者的抑郁、焦虑、疲劳、生活质量(QOL)、创伤后成长(PTG)、癌症复发恐惧(FCR)、疼痛和睡眠的有效性尚未确定。本研究旨在确定正念减压疗法在乳腺癌患者中的作用:目的:系统回顾文献,探讨正念减压疗法对乳腺癌患者焦虑、抑郁、QOL、PTG、疲劳、FCR、疼痛、压力和睡眠的影响。探讨 8 周与 6 周 MBSR 对 9 项指标的影响。从原始 RCT 研究中提取干预结束时和基线后三个月的数据,以探讨干预效果是否持续:我们在 PubMed、Web of Science、Embase 和中国国家知识基础设施上进行了检索,检索时间从开始到 2023 年 11 月。符合条件的研究包括乳腺癌患者接受正念减压干预的随机对照试验,报告了焦虑、抑郁、疲劳、QOL、PTG、FCR、疼痛、压力和睡眠的结果。两名研究人员分别对摘要和全文进行了审阅,提取了数据,并使用科克伦 "偏倚风险评估工具 "独立评估了偏倚风险。荟萃分析使用 Review Manager 5.4 进行,效应大小使用标准化平均差及其相应的 95% 置信区间确定:最终分析包括 15 项研究,共涉及 1937 名患者。在干预结束时,持续时间为八周的干预显著降低了焦虑[SMD=-0.60,95% CI (-0.78, -0.43),P 2 = 31%]、抑郁[SMD=-0.39,95% CI (-0.59, -0.19),P = 0.0019),P = 0.0001,I2 = 55%]和 QOL [542 名参与者,SMD = 0.54,95% CI (0.30,0.79),P 2 = 49%],而在持续 6 周的干预中未发现有统计学意义的效果。同样,在基线后的 3 个月内,为期 8 周的干预措施显著降低了抑郁程度和 QOL,但在为期 6 周的干预措施中未发现有统计学意义的效果。MBSR 可显著改善干预结束时的 PTG [MD = 6.25,95% CI (4.26,8.25),P 2 = 0%] 和基线后 3 个月的 PTG。我们发现,MBSR 在干预结束时减轻了疲劳状况,但对基线后 3 个月的疲劳状况没有显著影响。与常规护理相比,在改善疼痛、压力和 FCR 方面没有明显差异:结论:就对生活质量、焦虑、抑郁和疲劳的影响而言,为期 8 周的 MBSR 干预比为期 6 周的 MBSR 干预效果更好。MBSR 对 PTG 的干预是有效的,其效果持续到基线后 3 个月。未来的研究可以进一步确定 MBSR 中最有效的干预成分:试验注册:PROSPERO 注册号CRD42023483980。
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The use of mindfulness-based stress reduction (MBSR) for breast cancer patients-meta-analysis.

Background: Mindfulness-based stress reduction (MBSR) intervention has been widely used to reduce the burden of symptoms in cancer patients, and its effectiveness has been proven. However, the effectiveness of MBSR on depression, anxiety, fatigue, quality of life (QOL), posttraumatic growth (PTG), fear of cancer recurrence (FCR), pain, and sleep in breast cancer patients has not yet been determined. This study aims to determine the role of mindfulness-based stress reduction therapy in patients with breast cancer.

Objectives: The objective was to systematically review the literature to explore the effect of MBSR on anxiety, depression, QOL, PTG, fatigue, FCR, pain, stress and sleep in breast cancer patients. To explore the effect of 8-week versus 6-week MBSR on the 9 indicators. Data were extracted from the original RCT study at the end of the intervention and three months after baseline to explore whether the effects of the intervention were sustained.

Methods: We conducted searches on PubMed, Web of Science, Embase, and China National Knowledge Infrastructure from inception to November 2023. Eligible studies included randomized controlled trials of breast cancer patients who received mindfulness stress reduction intervention, reporting outcomes for anxiety, depression, fatigue, QOL, PTG, FCR, pain, stress, and sleep. Two researchers conducted separate reviews of the abstract and full text, extracted data, and independently evaluated the risk of bias using the Cochrane 'Bias Risk Assessment tool'. The meta-analysis utilized Review Manager 5.4 to conduct the study, and the effect size was determined using the standardized mean difference and its corresponding 95% confidence interval.

Results: The final analysis included 15 studies with a total of 1937 patients. At the end of the intervention, the interventions with a duration of eight weeks led to a significant reduction in anxiety [SMD=-0.60, 95% CI (-0.78, -0.43), P < 0.00001, I2 = 31%], depression [SMD=-0.39, 95% CI (-0.59, -0.19), P = 0.0001, I2 = 55%], and QOL [542 participants, SMD = 0.54, 95% CI (0.30, 0.79), P < 0.0001, I2 = 49%], whereas no statistically significant effects were found in the intervention with a duration of six weeks. Similarly, in 3 months after baseline, the interventions with a duration of eight weeks led to a significant reduction in depression and QOL, however, no statistically significant effects were found at the 6-week intervention. MBSR led to a significant improvement in PTG at end of intervention [MD = 6.25, 95% CI (4.26, 8.25), P < 0.00001, I2 = 0%] and PTG 3 months after baseline. We found that MBSR reduced the fatigue status at end of intervention, but had no significant effect on fatigue status 3 months after baseline. There was no significant difference in improving pain, stress, and FCR compared to usual care.

Conclusions: In terms of effects on QOL, anxiety, depression, and fatigue, the 8-week MBSR intervention showed better results than the 6-week MBSR intervention. The intervention of MBSR on PTG was effective, and the effect lasted until 3 months after baseline. Future studies could further identify the most effective intervention components in MBSR.

Trial registration: PROSPERO registration number: CRD42023483980.

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来源期刊
BMC Psychology
BMC Psychology Psychology-Psychology (all)
CiteScore
3.90
自引率
2.80%
发文量
265
审稿时长
24 weeks
期刊介绍: BMC Psychology is an open access, peer-reviewed journal that considers manuscripts on all aspects of psychology, human behavior and the mind, including developmental, clinical, cognitive, experimental, health and social psychology, as well as personality and individual differences. The journal welcomes quantitative and qualitative research methods, including animal studies.
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